Hospital Medical Bills and No Cash?

A typical US Hospital Stay Bill
A typical US Hospital Stay Bill

As more and more patients have become financially impaired due to the raising costs of health care, it is critical that patients become educated and knowledgeable of the options that are present and already in place to alleviate some of the financial burden.

The Joint Commission, an accrediting body that regulates acute care hospitals nationwide, has required for many years that all of their accredited facilities be compliant to their standards and regulations. One of which, has to do with patients that have become burdened by the hardship of high costs in the care they received from the treating hospital.

The accounts that pays the bill in lieu of the patient paying the tab, these accounts are generally funded by endowment accounts, monies left by former patients, and monetary gifts left by members of the hospital communities. Patients are required to fill out a request for hardship allowances to cover the costs of their health care, via an application that is then usually reviewed by a committee of folks that are supposed to be non-biased towards the approvals or denials.

The history has been for many years that patients with high bills needing to be paid would usually be sought after in the form of collection companies pursuing them to collect what monies that could by more normal and typical debt collection type processes. Often times, the hospitals do not do a very good job at all at informing the patient at the time of care, the options the patient has and the rights they have to know their options when they are confronted with unusually high bills post a urgent condition that required the point of delivery of the medical assistance.


Has any Hospital ever made you or your loved one aware of such accounts that are already in place for financial hardships?

  • Yes
  • No
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Financial Counselors, Case Managers, Discharge Planners, Utilization Review Nurses are the key individuals that usually always have the knowledge regarding these accounts, but they often fail at mentioning this as most patients and families fail to become verbal about finances at the time of the incident. It is not usually until the patient has achieved resolution and discharged that this is discussed, which is only after the bills begin to roll into the residences of the patient.

The current system of patient notification is broken and should be fixed. The simple fix could be a mandate by the Joint Commission that requires the hospitals notify the patient of the cost of care in the form of an estimate prior to the care being delivered. Much like the process we all know about from automobile mechanics. When your car is in need of service, we take it to the mechanic and he/she does the evaluation of what is needed, then the estimate is prepared in order to ascertain the actual approval for the cost of the repair. This protects both the consumer and the mechanic. Regretfully in health care, we don't even begin to discuss the cost of the care, if ever until after the patient has been serviced and then the patient is discharged completely paralyzed by what is approaching them only days later as it happens only days from discharge, they get bills that will worry, upset, and give them a fearful concern for their own financial ruin.

In fact, Medicare or CMS1 should be the gatekeeper for mandating this change that all hospitals that allow medicare patients would need to comply too in order to maintain their certification as a provider of Medicare services. Comments to this article is greatly appreciated, and with the comments we could work on an initiative to make Medicare wake up to the way patients are getting left out of the financial decisions that institutions so eagerly take on as the decision maker for their care.

So before you throw in the towel and give up on ever getting those hospital bills paid, remember to ask the hospital for an application to receive monies towards your debt to them via their financial hardship protocol and process. It could be a conversation that could end up saving you thousands of dollars and a lot of sleepless nights.


1. Center for Medicare and Medicaid Services (CMS)

© 2013 The Compliance Doctor

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